What Is Diabetic Ketoacidosis?


How Do You Prevent Diabetic Ketoacidosis?

Steps to Take to Avoid Diabetic Ketoacidosis

  1. Taking your insulin and/or medications as prescribed. If your physician tells you to take Lantus 10 units at bedtime, you should take it. If they ask you to take a certain amount of Novolog with meals, take it. It doesn’t mean you can’t question them if you feel that the dosing is inaccurate – It just means that if you don’t take your medication, you may end up with dangerously high blood sugar levels.
  2. Check your blood sugar! Often, insulin is dosed according to your blood sugar levels so knowing these numbers is important. If you don’t take insulin for the treatment of your diabetes, knowing your blood sugar levels is also important – it helps you and your physician know how well your treatment regimen is working, plus it lets you know if your lifestyle habits need “tweaking.”
  3. Ask your physician for a referral to a certified diabetes educator (CDE). CDEs can help with many things – such as insulin management, education on those “lifestyle habits,” and can help if you think things may be going haywire.
  4. Know exactly what to do if you think you may have DKA. There is a process you should follow that may keep you out of danger – or at least get you to the hospital as quickly as possible.

Please continue reading so that you know what to do if you suspect you have DKA.

What to Do If You Suspect You May Have Diabetic Ketoacidosis?

As hard as it may be, do not panic.

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Objectively, look at your symptoms. Do they match up with the symptoms above? Then, check your blood sugar. Is it dangerously high? Think back. Have you been ill or stressed? Stress to the body – mental, physical, emotional – can cause an increase in blood sugar levels. Or did you omit insulin – intentionally or accidentally?

If your symptoms match up with symptoms listed above and your blood sugar is high, you need to check your ketone levels.

How to Check Your Ketone Levels

Here’s how to check your ketone levels. Although there are meters that can test your blood ketones, most insurance plans do not cover this type of testing, and it is costly, so it is more practical to purchase urine ketone testing strips.

For this reason, we will outline the steps for urine ketone testing:

  1. While urinating, pass the ketone strip into the urine stream. You may also urinate into a clean container and dip the ketone strip into the clean sample of urine if it is difficult to pass the strip into the urine stream.
  2. Shake any excess urine off of the ketone strip.
  3. Each bottle of ketone strips will tell you how long to wait before checking for results; refer to your bottle of ketone testing strips.
  4. Once you have waited the allotted amount of time, check the strip. It should have changed color. Compare the color to color chart on the bottle. The color chart will tell you an estimate of the amount of ketones in your urine.
  5. Use the ketone chart to decide what you should do next.

The charts will typically state that your ketones are “trace” or “small,” “moderate,” “large” or “very large.” When your ketones are “trace” or “small,” ketones are starting to build and may be able to be managed at home.

Contact your physician or CDE – they may ask you to give additional insulin, change your insulin pump infusion site (if you utilize an insulin pump), and other self-care measures, such as proper hydration.

However, if your ketones are “moderate” or larger, it is typically recommended to seek emergency medical attention. Ketones can build up very quickly, and it can turn dire very quickly.

Can I Get Diabetic Ketoacidosis If I Have Type 2 Diabetes?

Generally speaking, DKA is much more common in people who are diagnosed with type 1 diabetes than with type 2 diabetes. In fact, in the past, it was almost unheard of for someone to present with type 2 diabetes and DKA.

However, it is becoming increasingly more common for someone with type 2 diabetes to present to an emergency department with DKA. Why?

According to The BMJ, “some people with type 2 diabetes may develop acute reductions in insulin production, which, coupled with insulin resistance, can cause DKA, usually without a precipitant.” People with type 2 diabetes who are prone to developing DKA are considered “ketosis-prone type 2 diabetic”.

This does not mean that every person with type 2 diabetes is prone to developing DKA. In fact, studies suggest that most people with type 2 diabetes will not go on to develop DKA.

Studies indicate that African-Caribbean and other non-white ethnic groups are more likely to have ketosis-prone type 2 diabetes; “observational studies in African-Caribbean people presenting with ketoacidosis indicate that 20-50% have type 2 diabetes.”

The Bottom Line…

DKA is almost always unavoidable if you take the proper steps in treating and managing your diabetes. However, knowing how to detect DKA and then what to do if you suspect you have DKA is of the utmost importance as it can save your life.

References

American Diabetes Association (Checking for Ketones)

American Diabetes Association (DKA & Ketones)

The BMJ (Diabetic Ketoacidosis: Not Always Due to Type 1 Diabetes)

Mayo Clinic (Diabetic Ketoacidosis – Causes)

Mayo Clinic (Diabetic Ketoacidosis – Complications)

WebMD (Diabetic Ketoacidosis – Topic Overview)

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